Use of Direct Oral Anticoagulants After Percutaneous Coronary Intervention

Abstract

Atrial fibrillation (AF) is the most common cardiac rhythm disorder and often requires oral anticoagulation (OAC) in order to decrease the risk of thromboembolic complications, such as stroke and systemic embolic events. Unless contraindicated, current guidelines suggest that direct oral anticoagulants (DOAC) should be preferred over vitamin K antagonists. Of note, nearly 30% of AF patients also present with concomitant coronary artery disease requiring percutaneous coronary intervention (PCI) as well as dual antiplatelet therapy (DAPT) to prevent adverse cardiac events. So, a sizeable proportion of patient’s needs to be treated with a combination of OAC and DAPT, a regimen also known as triple antithrombotic treatment, which in turns will substantially increase the risk of major and fatal bleedings.